Inflammation of the gastric cardia in children with symptoms of acid peptic disease.

Objectives: To assess the severity and causes of inflammation of the gastric cardia in children undergoing endoscopy for symptoms of acid peptic disease.Study Design: Patients undergoing upper gastrointestinal endoscopy for symptoms of acid peptic disease had biopsies from gastric cardia, gastric, a...

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Publicado en:Journal of Pediatrics Vol. 143; no. 4; pp. 520 - 525
Autores principales: Borrelli O, Hassall E, D'Armiento F, Bosco S, Mancini V, Di Nardo G, Bueno de Mesquita M, Cucchiara S, Borrelli, Osvaldo, Hassall, Eric, D'Armiento, Francesco, Bosco, Sandro, Mancini, Valentina, Di Nardo, Giovanni, Bueno de Mesquita, Mirjam, Cucchiara, Salvatore
Formato: pictorial research tables/charts Journal Article
Publicado: Elsevier B.V. 2003 Oct
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2003 Oct
      vid: 143
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      pub: Elsevier B.V.
      place: New York, New York
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        atl: Inflammation of the gastric cardia in children with symptoms of acid peptic disease.
      aug:
        au:
          Borrelli O
          Hassall E
          D'Armiento F
          Bosco S
          Mancini V
          Di Nardo G
          Bueno de Mesquita M
          Cucchiara S
          Borrelli, Osvaldo
          Hassall, Eric
          D'Armiento, Francesco
          Bosco, Sandro
          Mancini, Valentina
          Di Nardo, Giovanni
          Bueno de Mesquita, Mirjam
          Cucchiara, Salvatore
        affil: Departments of Pediatrics and Pathology, University of Naples Federico II, Naples, Italy
      sug:
        subj:
          Inflammation Etiology
          Peptic Ulcer Complications
          Stomach
          Adolescence
          Canada
          Child
          Child, Preschool
          Convenience Sample
          Descriptive Research
          Descriptive Statistics
          Female
          Gastric Acidity Determination In Infancy and Childhood
          Gastritis Etiology
          Helicobacter Infections
          Male
          Monitoring, Physiologic In Infancy and Childhood
          Prospective Studies
          Human
          Adolescent: 13-18 years
          Child: 6-12 years
          Child, Preschool: 2-5 years
          Female
          Male
      ab: Objectives: To assess the severity and causes of inflammation of the gastric cardia in children undergoing endoscopy for symptoms of acid peptic disease.Study Design: Patients undergoing upper gastrointestinal endoscopy for symptoms of acid peptic disease had biopsies from gastric cardia, gastric, and esophageal sites, and 24-hour intraesophageal pH monitoring. Gastric cardia was defined at endoscopy as the anatomic zone from the squamocolumnar junction to 0.5 cm below it. Severity of gastric cardia inflammation was scored 0 to 9 according to densities of inflammatory cells and epithelial abnormalities in surface and pit epithelium. A score > or =2 was considered positive.Results: Forty-seven children (median age, 6.5 years; range, 3-15) had Helicobacter pylori infection, gastroesophageal reflux disease (GERD), or both. In 22 patients, H pylori was detected in cardiac biopsies by rapid urease test and histology; it was detected also in the corpus and antrum in only seven of the 22. No patient had H pylori in gastric corpus/antrum without having the organism at the cardia as well. In 12 H pylori-positive patients, GERD was also diagnosed. Twenty-five patients had GERD and no H. pylori infection. Severity score was 3.8+/-0.8 in the H pylori group and 2.08+/-0.9 in the GERD alone group (P<.001); however, there was no difference in reflux index (24-hour % of gastroesophageal reflux) between the two groups. In neither group was correlation found between reflux index and severity score (H pylori, r=0.22; GERD alone, r=0.31; NS) nor between cardia inflammation and esophagitis grade (H pylori, r=0.37; GERD alone, r=0.22; NS).Conclusions: In children with symptoms of acid peptic disease, inflammation of the gastric cardia does occur. It is more severe when the cardiac zone is infected with H pylori than in its absence. Of major practical significance is the finding that the gastric cardia is a highly sensitive site for the detection of H pylori infection.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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